Pregnancy, Childbirth and Your Pelvic Floor: Understanding the Connections

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Fortunately, incontinence and pelvic floor symptoms are finally gaining recognition as common problems that affect women young and old, ones that can severely diminish the self-confidence and physical function of women trying to maintain full and active lifestyles.

In many cases, pelvic floor problems attest to the extraordinary physical demands of pregnancy, labor, and delivery – though they often arise years or even decades afterwards. 

Urogynecology is the first women’s health specialty devoted to the treatment of these disorders, and as such, is offering brand new perspectives on childbirth and its potential aftereffects.  Indeed, the lifestyle and childbirth decisions of today’s 30-year-old may impact key aspects of her physical function at age 40, 50 or 60.  Just the same, incontinence, prolapse or sexual dysfunction experienced by a 50-year-old may relate to choices she made during childbirth, years before. 

Doctors, nurses and researchers in urogynecology are committed to promoting a better understanding of these conditions and their causes, and to helping women make informed decisions at every stage.

Are Incontinence and Pelvic Floor Problems Inevitable After Childbirth?
Not inevitable – but common.  Generations of women have regarded incontinence and pelvic floor problems as inescapable ‘costs of motherhood’, silently accepting their loss of control and self-confidence.  But the fact is that today – despite the fact that childbirth is a major risk factor leading to urinary incontinence, anal incontinence and pelvic prolapse – for most women these problems are either preventable or treatable.

If you are an expectant mother or contemplating having a baby, learning about ‘what to expect while you’re expecting’ is important – but just as importantly, you should know what to expect over the years that follow, and understand how to prevent problems in the first place.  Did you know that pelvic exercises might lower your risk of incontinence after delivery?  Are you aware of the risks and benefits of forceps delivery or episiotomy, and what their proper role should be?  What are the effects of perineal massage, and alternative pushing techniques?  Did you know that the length of time you choose to push might relate to your risk of incontinence later on?  When is ‘choosing a cesarean’ a reasonable option to discuss with your doctor or midwife?  Certain decisions made during this process have consequences that can last a lifetime.

If you’re already a mother and are contemplating having another child, you may be wondering if mild problems with bladder control will get worse, or whether your obstetrical strategy should be different than before.  You should be aware that ‘normal life’ in the years ahead is not a daily routine of pads and liners, or a struggle with symptoms that diminish your enjoyment of life at home or work, at the gym or in the bedroom.

Adapted From:  “Ever Since I Had My Baby: Understanding, Treating and Preventing the Most Common Physical Aftereffects of Pregnancy and Childbirth”, by Roger P. Goldberg, MD MPH

(Crown Publishers, Random House, NY 2003)

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